Application: All household members must be listed. Failure to include all persons living in your household is considered fraud. Fraud can result in a denial of assistance or repayment of any assistance received. Make sure to complete questions and sign & date the application.
Social Security Number Verification: Social security cards for all household members. (Please note we cannot accept 1040 tax forms for social security numbers due to the fact a lot of taxes are being completed by the head of household.)
If you cannot provide your social security card, the following documents may be used along with a government-issued photo ID:
- Family Demographic (Office of Family and Children) printout with Social Security numbers
- Military or Government Identification or Benefit Statement
- W-2’s (For social security number purposes, adults only)
- A birth confirmation letter from the hospital may be used for children under 1 that do not have a social security card yet
Driver’s License / Picture ID: A state-issued photo ID for the applicant that has a star in the top-right corner
Veteran: Please provide documentation such as a DD Form 214 or Veteran’s Administration Identification Card (VIC)
Income Information: All adults in the household 18 and older must provide proof of income
Wage Inquiry (WorkOne required only if the client is getting unemployment)
Forms of income
- Please provide your most recent pay-stub. If you have not worked there in the past 3 months, we need an income affidavit filled out (zero income form). Please state when the client started the job and if the client works full or part-time
- Please provide your final pay-stub if you have worked within the last 5 months and are no longer employed with that employer
- Social Security Benefits (SSI, SSDI, SSD, SSA) / VA Pension / Veteran’s Benefit
Current Award Letter: Must be dated within the current year. An award letter dated over a year old will not be accepted
Current Bank Statement: Statement must clearly show “United States Treasury deposit” and to whom it is for. The bank statement cannot be marked out for any reason
Pension: Most recent check stub OR current pension award letter
Self Employed: Completed IRS form 1040 page 1 & 2, Schedule C page 1 & 2, and SE if applies for previous tax year
Zero Income Verification Affidavit / Cash Income: If anyone in the household has had 1 month or more of no income, this form must be filled out. One form per household member
Housing Information:
- Rent: Anyone who has utilities included in their rent will need a landlord affidavit filled out
- All Landlord affidavits must be completed by the Landlord
Utility Bills:
- The current utility bill (lower portion of the bill that you mail back to the vendor will not be accepted). Must be the full bill and the current month
- If the utility bill is not in a household member, landlord, or Power of Attorney’s name, we will need a utility affidavit filled out and possibly an absent household member form
- Current LP / Oil Invoice (the invoice must show name, vendor name, account number, service address, and budget billing)
Additional Documentation:
- As each application is case by case, additional documentation may be requested
- ANY missing information may delay decisions regarding your eligibility and benefit amount. Your application will be processed as it is received. Failure to provide required documents may result in delay or denial of your application
